Department of Endocrinology, Clinical Center of Montenegro, Podgorica, Montenegro.
Department of Pathology, School of Dental Medicine, University of Belgrade, Belgrade, Serbia.
Indian J Med Res. 2021 Jun;154(6):857-865. doi: 10.4103/ijmr.IJMR_478_20.
BACKGROUND & OBJECTIVES: Drospirenone (DRSP) is a progestin with antimineralocorticoid and anti-androgenic activity. When administered in combination with estradiol (E2), it relieves menopausal symptoms. The aim of this study was to evaluate the effects of DRSP/E2 on the reduction of cardiovascular risk factors in menopausal women with hypertension.
A retrospective study was conducted at the Clinical Center of Serbia. The participants were 64 menopausal women [mean age=49.19±4.62 yr, mean body mass index (BMI)=25.08±2.94 kg/m, mean amenorrhoeic period=2.48±2.46 yr]. The effects of DRSP 2 mg/E2 1 mg on 24 h blood pressure (BP) variability, heart rate (HR), anthropometric characteristics and hormone and lipid levels were evaluated in early menopausal women with previously untreated stage 1 hypertension. All analyses were carried out before and after six and 12 months of therapy.
DRSP/E2 significantly reduced daytime BP values during six and 12 months of therapy. The reductions in systolic and diastolic BPs ranged from about -4.50 to -8.50 and from -4.00 to -5.00 mmHg, respectively. There were no significant changes in nocturnal 24 h BPs. DRSP/E2 significantly reduced HR daytime and night-time during the follow up period. DRSP/E2 significantly lowered the BMI, concentrations of total cholesterol, low-density lipoprotein cholesterol and apolipoprotein B, while high-density lipoprotein cholesterol and apolipoprotein concentration increased.
INTERPRETATION & CONCLUSIONS: Continuous long-term therapy with DRSP 2 mg/E2 1 mg significantly lowered 24 h systolic and diastolic BPs and reduced the risk of cardiovascular disease in early menopausal women with stage 1 hypertension. Timely initiated menopausal hormone therapy can have beneficial effects on BP and can reduce the incidence of cardiovascular disease in menopausal women.
屈螺酮(DRSP)是一种具有抗盐皮质激素和抗雄激素活性的孕激素。当与雌二醇(E2)联合使用时,它可以缓解更年期症状。本研究旨在评估 DRSP/E2 对降低高血压绝经后妇女心血管危险因素的影响。
这是一项在塞尔维亚临床中心进行的回顾性研究。参与者为 64 名绝经后妇女[平均年龄=49.19±4.62 岁,平均体重指数(BMI)=25.08±2.94 kg/m,平均闭经期=2.48±2.46 年]。在未经治疗的 1 期高血压的早期绝经后妇女中,评估了 DRSP 2 mg/E2 1 mg 对 24 小时血压(BP)变异性、心率(HR)、人体测量特征以及激素和脂质水平的影响。所有分析均在治疗前、治疗后 6 个月和 12 个月进行。
DRSP/E2 治疗 6 个月和 12 个月后,显著降低了白天的 BP 值。收缩压和舒张压的降低范围分别约为-4.50 至-8.50 mmHg 和-4.00 至-5.00 mmHg。夜间 24 小时 BP 无明显变化。DRSP/E2 治疗期间,白天和夜间的 HR 显著降低。DRSP/E2 显著降低了 BMI、总胆固醇、低密度脂蛋白胆固醇和载脂蛋白 B 的浓度,同时高密度脂蛋白胆固醇和载脂蛋白浓度增加。
连续长期使用 DRSP 2 mg/E2 1 mg 可显著降低早期绝经后妇女 1 期高血压患者的 24 小时收缩压和舒张压,降低心血管疾病风险。及时开始的绝经激素治疗对 BP 有益,并可降低绝经后妇女心血管疾病的发生率。